After greeting everyone in the office, Rep. Casimiro walked through all of the BAYADA Rhode Island offices with a sense of curiosity and helpfulness. She asked about the services we provide, where our clients and employees are located, and the challenges we face.

Cristina Gomes took Rep. Casimiro into the Rhode Island Skilled Pediatric SIM Lab to demonstrate the sophisticated training we offer and how we use it to support our nurses and clients in the home. Cristina explained each piece of equipment and provided scenarios where she has been able to successfully use the lab, as well as virtual and in-home training to advance nurses, skills to care for medically complex children outside of a facility of hospital setting. She explained how we reevaluate each nurses skills annually and provide ongoing support as needed to make sure our nurses are confident, competent and prepared for any emergency.

We stood in front of the large white board with all of our open shifts, while she skimmed the cities and noticed there were in fact several pediatric clients in her District who are not currently receiving all of the PDN nursing services they are authorized for. She was determined to find out why this is happening and how she can help everyone on that board. The office staff explained that because the reimbursement rates for Medicaid mean that nurses pay rates at home are significantly lower than what they can earn in a hospital or facility. Even Massachusetts rates are approximately 40 percent higher than in RI, so our state’s nurses are traveling across state lines to care for people in other states instead of staying her to care for our vulnerable Rhode Islanders. It was clear that Rep. Casimiro completely understood the issue while we walked away from the board, towards the SIM Lab – she was shaking her head and said “How can I help? I want to help fix this”

Rep. Casimiro not only asked detailed and thoughtful questions about home care nursing and CNA services, but committed to a home visit with a pediatric client. She even offered her assistance with any legislation we propose this session to help ensure Rhode Islanders get the home care they need!

Thank you, Rep. Casimiro for being a friend of home care! For information about how you can get involved in advocacy on behalf of your staff and clients, contact me today!

Recently, Deputy Medicaid Program Director Marlanea Peabody and Chief of Staff John Bonin visited Rhode Island Skilled (RIS) client Kevin to learn about the high acuity nursing services that Kevin receives from his long-time BAYADA nurse, Larry, and about the struggles that he and his family have recently faced due to issues within the state.

This year, Kevin’s home care nursing coverage switched from Neighborhood Health Plan of RI’s Managed Medicaid Plan to Medicaid Fee-for-Service, which caused the nursing reimbursement rates to drop more than $10.00 per hour. Kevin’s parents explained to Marlanea and John the challenges of navigating the medical coverage options for their son, as well as the added stresses of worrying about the effect the lower rate will have on Kevin’s nurse, Larry. Mom elaborated further about the unfortunate nature of their situation – that all of this is weighing on them while also dealing with the emotions surrounding the inevitability of Kevin’s diagnosis of Duchene’s Muscular Dystrophy.

Larry has been Kevin’s nurse for more than eight years. Seeing them together is like watching two best friends hang out – there’s always laughter and joking! They go bowling every Thursday, watch football, go to races and you can clearly see they enjoy each other’s company. With the transition of Kevin’s medical plan going from Managed Medicaid to Fee-for-Service, there is a possibility that with the drastic reduction in reimbursement rates that Larry’s pay may be reduced. If Larry decided to leave Kevin because of reduced rates to make more money elsewhere, not only would the family lose the ability to work, support their household and maintain some type normalcy, but Kevin would be devastated!

The home visit focused on educating our regulatory officials about what high-tech nursing involves, what home care nurses are responsible for, the value of continuity of care with consistent nursing and the quality of life Kevin has because of his long time nurse, Larry.

Both Marlanea and John asked great questions, engaged on high level discussion with mom and dad about the program transition and left the visit saying how grateful they were for the opportunity. They had the chance to not only witness Kevin’s high-tech care but also his strong bond with his nurse Larry.

Thank you to our regulators for attending this home visit and for being so receptive and responsive to Kevin and his family’s needs. Thank you to RIS Clinical Manager Bob Cardin and RIS Director Rick Boschwitz for coordinating this important visit with Kevin, his family, and Larry!

Home Visit 2: House Speaker Nicholas Mattiello Visits Corinna Calise, Who Relies on Home Care to Live with Her Family

Corinna’s parents, Michelle and Michael, first learned their daughter had Spinal Muscular Atrophy (SMA) when she was just 11 months old. “We were told to take our daughter home and enjoy whatever time we can with her because she’s not going to live to see her second birthday,” Michelle said. Now, thanks to the in-home care she receives, Corinna is thriving nearly 20 years later. Due to her condition, her nurses must have specialized training in life-sustaining equipment for tracheostomy care and ventilator maintenance, which allows Corinna to stay in her home with her family, instead of living in a facility. “People who don’t know us and see Corinna’s condition, say ‘how do you do it?’” Michelle said. “I will admit it can be difficult, but we feel blessed. Corinna is so much fun; she interacts as a typical young adult mentally and emotionally.”

Corinna and her family welcomed their Representative and Speaker of the House Nicholas Mattiello (D-Cranston) into their home for a visit to learn more about home care and the nurses providing Corinna’s care. Corinna is in college now, and she loves advocacy and policy and is considering going into Political Science. When the Speaker heard of Corinna’s interest in politics, he offered his help by inviting her up to sit in on session and get a behind the scenes tour of his office and House Chambers.

Corinna, her nurse, and her mom offered insight into some of the challenges with her home care nursing. Specifically, they discussed the low reimbursement rates for Medicaid which are not able to provide fair wages to highly trained nurses, like Corinna’s who must be able to provide tracheostomy care and ventilator maintenance. It’s imperative that they be ready at a moment’s notice if there should be an emergency, while also knowing the faint signs Corinna displays where there is an underlying issue developing. The Speaker was asking great questions to probe further discussion about how vital her nurses are to her wellbeing. When Corinna was asked, “If you had a blank check, how much would you pay your nurses?” she replied by said “A LOT!”

During his visit, Speaker Mattiello was presented with a Legislative Champion Award by the Rhode Island Partnership for Home Care for his advocacy on behalf of home care and hospice providers, their direct care staff, their patients and clients and their families.

We are beyond grateful to have Speaker Nicholas Mattiello as a champion for home care! Thank you to everyone involved with this impactful visit!

It is important that we advocate for our staff and clients and show our legislators and regulators how Medicaid rates and other state and federal policies impact home care. For information on ways you can get involved in advocacy, contact me today.

Mitzi Page and her son, Kyle, both of East Providence, are one of the several families that were covered in the media in an effort to increase Rhode Island’s reimbursement rates for in-home skilled nursing services.

BAYADA’s Government Affairs Office (GAO) always seeks new ways to accomplish BAYADA’s legislative goals. In the past two years, GAO solidified a grassroots advocacy team to engage staff, clients, and families in advocating for better home care rates and policies. Even more recently, GAO has begun to see how much media attention on home care issues can further our message and help us reach our legislative goals.

Earlier this year, BAYADA contracted with Regan Communications to bring attention to the need for a state Medicaid reimbursement rate increase. Regan helped BAYADA gain the media coverage necessary to reveal Rhode Island families’ access to care issues and the bleed-out of in-home nurses, who are better paid to do similar work in other settings and neighboring states. Regan was able to assist BAYADA in gaining the momentum necessary to successfully bring the increase across the finish line!

GAO is pleased to announce that BAYADA has extended our contract with Regan through the end of the year. Additionally, GAO is exploring a more extensive contract with Regan across our major media markets, and has expanded our in-house public affairs program with Public Affairs Manager Alisa Borovik.

Our 2017 Ambassador of the Year winners pose with Chief Government Affairs Officer Dave Totaro and US Senator Debbie Stabenow

The Hearts for Home Care (H4HC) Ambassador role is a voluntary assignment for BAYADA office employees who are interested in going above and beyond for their staff and clients through advocacy. The H4HC Ambassador serves as the point of contact between the BAYADA Government Affairs Office (GAO) and the Ambassador’s home office. Ambassadors’ primary responsibility is to develop and foster relationships with their local legislators through meetings and home visits. These meetings ensure that our state decisionmakers are educated on home care and understand the immense impact our industry has on their constituents. Most legislators are not familiar with home care, so the more we tell them about our staff and clients, the more likely they are to support reimbursement rate increases and other policies favorable to home care. Additionally, top Ambassadors are recognized at our yearly Ambassador Awards trip, and all Ambassadors get exclusive invitations to fundraisers and other events throughout the year.

GAO’s goal is to have at least one Ambassador per office in both Rhode Island and New York. It is vital that someone can communicate updates and initiatives during staff meetings from our H4HC team to your colleagues and educate local legislators about home care and the issues we and our clients face daily. If you are interested in becoming an Ambassador, email Mike Sokoloski to learn more about the program and our bi-monthly onboarding Zoom for new Ambassadors.

Can’t commit? Even if you are not interested in becoming an Ambassador at this time, all staff, clients, and supporters of home care are encouraged to join Hearts for Home Care and like our Hearts for Home Care Facebook Page to stay up-to-date on client stories, legislative accomplishments, and home care news.

GAO Director Ashley Sadlier and home care staff and clients advocate in support of a bill before a hearing in the Rhode Island state house

GAO is excited to announce its first legislative accomplishment in Rhode Island: A Medicaid rate increase for personal care and skilled care services! The 10 percent increase to CNA services and 20 percent increase to nursing services are effective as of July 1, 2018. The State of Rhode Island intends to implement these rates by October 2018 and payments to services will be made retroactive. This increase will allow for BAYADA’s Rhode Island service offices to recruit and retain more quality caregivers and care for more Rhode Islanders that want to remain independent and healthy at home with their families.

We couldn’t have done it without you. BAYADA staff, clients, and families were instrumental in this win. Advocates submitted nearly 25 testimonies to legislators, spoke at hearings, and participated in online action alerts. While BAYADA’s Government Affairs Office (GAO) and our state partners supplemented your messages media coverage and direct lobbying to ensure continued pressure on legislators and governor, the quick and efficient mobilization of our office staff, field staff, was our secret sauce! It was inspiring to watch our advocates take initiative and transform their passion into action.

In addition to this monumental increase, the legislation included a Cost of Living adjustment (COLa), which is unprecedented. A COLa ensures that the governor and legislature must include yearly increases for these home care services in each budget going forward. The COLa will be dictated by a national database, specific to health care costs.

But our work isn’t done yet. Rhode Island’s reimbursement rates remain approximately 20-30 percent less than Massachusetts’s rates. Without additional increases, we will continue to face challenges with recruiting, training, and retaining high quality caregivers because they can make a higher wage in other settings.

This legislative session, we are continuing to educate our elected officials about why it is imperative that the state support and invest in home care services to keep our medically fragile Rhode Islanders at home. GAO has scheduled meetings with legislators, coordinated home visits and roundtable discussions with elected officials and regulators, and have developed the tools and resources necessary for our in-office and client advocates to take action.

Thank you to all our advocates – the progress Rhode Island has made is a direct reflection of your engagement and your willingness to share your stories! To learn about how you can get involved in advocacy, email advocacy@bayada.com.

The Government Affairs Office (GAO) is excited to announce its expansion into New York and Rhode Island! Expansion into both states means that GAO can begin directly lobbying state lawmakers for better home care policies and reimbursement rates, and can begin to directly involve New York and Rhode Island staff, clients, and families in advocacy efforts.

What is GAO’s mission?

The BAYADA Government Affairs Office (GAO) will represent the Company to all levels of local, state and federal government entities, regulatory agencies and community organizations (What we do)

Our mission is to act as a voice for our clients, their families and our employees through education, advocacy, service and research (What makes us different)

This will result in legislation, regulation, and policies which are supportive of home care services that provide the highest quality of care and will enable patients to remain in their homes (What benefits our clients receive)

What are GAO’s goals?

Build awareness

Secure adequate resources

Foster policies supportive of home health care

Engage staff and clients in advocacy on behalf of BAYADA staff and clients

How does GAO accomplish its mission and goals?

GAO operates through a three-pronged approach:

Direct Lobbying: Accomplished mainly through the GAO director as determined by BAYADA leadership in the state

Supporting our Champions: BAYADA supports state and federal legislators that support home care. Legislators that support home care understand our industry’s issues and our staff and clients’ needs. BAYADA supports our champions largely through our state and federal Political Action Committees (PACs). Rhode Island and New York do not yet have PACs, but stay tuned! Full-time, exempt and salaried office employees are able to support our federal legislators by joining BAYADA’s federal PAC.